Lower Frequency Limit of Measuring System in HZ
(+/-3.dB)
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Maximum Level in dB
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---|---|
0.1 Hz high pass system
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134 peak
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2 Hz high pass system
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133 peak
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5 or 6 Hz #2 high pass system
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129 peak
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C-slow
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105 peak dBC
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Limits -
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Each Occurrence: one million dollars ($1,000,000.00).
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Personal and Advertising Injury: one million dollars ($1,000,000.00).
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Products/Completed Operations
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Aggregate: one million dollars ($1,000,000.00).
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General Aggregate: five hundred thousand dollars ($500,000.00).
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Policy MUST include the following conditions:
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Contractual Liability
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Personal and Advertising Injury
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Products/Completed Operations
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Explosion, Collapse and Underground Certificate must confirm
inclusion of "Blasting" coverage, if applicable
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Independent Contractors
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Broad Form Property Damage
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i. Any Auto or
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ii. All Owned Autos; Hired Autos; and Non-Owned Autos
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Limits -
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Each Accident, Combined Single
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Limits, Bodily Injury and
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Property Damage: one million dollars ($1,000,000.00).
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Workers Compensation: Statutory
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Employers Liability -
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Bodily Injury by Accident: one hundred thousand dollars ($100,000.00)
Each Accident
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Bodily Injury by Disease: five hundred thousand dollars ($500,000.00)
Policy Limit
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Bodily Injury by Disease: one hundred thousand dollars ($100,000.00)
Each Employee
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i. General Liability
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ii. Automobile Liability
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iii. Employers Liability
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The City of Greenwood shall be named as an additional insured.
Umbrella, or Excess Liability requirements may be modified or waived
at the City's discretion upon written application to and approved
by the City's risk manager (or risk management consultant). If the
requirement is modified or waived, the risk manager (or risk management
consultant) shall place on file with the City manager (or risk management
consultant). If the requirement is modified or waived, the risk manager
(or risk management consultant) shall place on file with the City
their reasoning for such waiver or modification.
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CITY OF GREENWOOD, MISSOURI
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DATE: _____
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4 COPIES:
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CONTRACTOR
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FIRE ALARM OFFICE -
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DISPATCH
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FIRE CHIEF, FIRE DEPARTMENT
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CITY CLERK
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ORIGINAL:
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PUBLIC WORKS DIRECTOR
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1. LEGAL DESCRIPTION OF PROPERTY UPON WHICH BLASTING IS TO BE
PERFORMED:
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__________
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__________
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2. LOCATION OF BLASTING SITE: __________
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3. NAME/ADDRESS OF APPLICANT (if applicant is a corporation,
list state of incorporation):
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__________
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__________
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4. TELEPHONE NUMBER OF APPLICANT
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a. Daytime Telephone: __________
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b. Emergency Telephone: __________
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5. NAME OF RESPONSIBLE PARTY (individual name):
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__________
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6. NAME(S) OF QUALIFIED BLASTER(S) (include individual's age
and years of experience):
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__________
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__________
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7. APPROVED INSURANCE CERTIFICATE PROVIDED?
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_____ YES _____ NO
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8. PURPOSE OF BLASTING: __________
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__________
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9. DOES APPLICANT HAVE THE LEGAL RIGHT TO ENTER UPON THE AFFECTED
AREA? __________ (PROVIDE DOCUMENTATION)
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10. APPLICANT MUST PROVIDE ACCURATE MAPS OF A SCALE OF NOT LESS
THAN ONE (1) INCH TO ONE HUNDRED (100) FEET CLEARLY SHOWING:
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a. The land proposed to be affected during the period of the
permit including all boundaries of the land to be affected.
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b. Location of the closest structures to the permit area in
any area.
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c. All easements of record, public and private, which cross
the permit area.
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11. HAS THE APPLICANT, A SUBSIDIARY, AFFILIATE, OR PERSONS CONTROLLED
BY OR UNDER COMMON CONTROL WITH THE APPLICANT, EVER HELD A BLASTING
PERMIT IN ANY STATE OR POLITICAL SUBDIVISION WHICH IN THE FIVE-YEAR
PERIOD PRIOR TO THE DATE OF SUBMISSION OF THIS APPLICANT BEEN SUSPENDED
OR REVOKED?
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_____ YES _____ NO
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12. PRESENCE OF DAY BOX: _____ YES _____ NO
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13. EXACT LOCATION OF DAY BOX:
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__________
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14. MATERIAL USED IN BLASTING:
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a. Type and class of explosives: __________
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b. Amount (lbs.) of each type: __________
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c. High? _____ Low? _____ Blasting Agents? _____
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Cap No(s) _____ Initiating Explosives? _____
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Ammonium Nitrate? _____
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15. SEISMOGRAPHS:
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a. Must be provided for each blast. This includes documentation
and seismogram provided upon request by the City Engineer.
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b. Type of unit in use: __________
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Is unit self triggering? _____ Yes _____ No
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Is unit self calibrated? _____ Yes _____ No
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Name of person with seismograph: __________
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Provide documentation.
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16. SPECIAL CONDITIONS. The following rules shall be followed:
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* NO SMOKING allowed within fifty (50) feet of any location
where explosives are being handled or stored. This includes no fire
or flame of any type.
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* During the time of loading explosives into holes, the blast
site shall be barred to all but those authorized persons engaged in
the drilling and loading operations or otherwise authorized to enter
the site for specific associated reason. The blast site shall be guarded
and posted.
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* Post City blasting permit in a visible location on site; an
approved blaster on file with this office must be present during all
blasting activity and present certificate authorization and photographic
identification upon request by the City of Greenwood. Please report
any loss of blasting permit to the Public Works Department immediately.
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* The City of Greenwood shall have the right to enter construction/blasting
sites before, during, or after blasting.
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* False information provided to the Public Works Department
on this application sheet will result in revocation of permit and
the site closed by the City of Greenwood.
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* The person(s) in charge of blasting on site must follow all
city, state and Federal requirements. Any person or company found
not following requirements will have permits revoked and the site
closed by the City of Greenwood.
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* When blasting is being conducted in the vicinity of gas, electric,
water, fire alarm, telephone, telegraph or stream utilities, the blaster
shall notify the appropriate representative of such utilities at least
twenty-four (24) hours in advance of blasting specifying the location
and intended time of such blasting.
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* Precautions shall be taken to prevent the premature detonation
of explosive materials from lightning, radio frequency energy, extraneous
electricity or static electricity caused by dust or snow storms, low
humidity or mechanical conditions. Such precautions shall include
the suspension of blasting operations and removal of persons from
the blasting area during the approach and progress of a thunderstorm.
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* Tools used for the opening of containers of explosive materials
shall be made of non-sparking materials.
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EXCEPTION: Slitters of metal are allowed for opening paper,
plastic or fiberboard containers.
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* Empty boxes and paper, plastic or fiber packing material which
have previously contained materials shall not be reused, and shall
be disposed of in a manner approved by the City Engineer.
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* Blasting permits will be issued by the Public Works Department
for ninety-day periods only. If any changes are made which affect
the information given on the initial permit application, the initial
permit will become null and void, therefore another application must
be made including all original fees.
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* Completed applications and plans shall be submitted to the
City Engineer for review. Applicants will be notified when plan review
is completed as to further information needed or approval. Blasting
permits will be issued upon appropriate review by the Public Works
Department and the payment of permit fee. A minimum twenty-four-hour
notice should be expected for an approval to be returned to the contractor.
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* All storage of explosives in excess of that amount required
for one (1) day's use, requires a permit to be issued by the Fire
Department. The day box storage of that amount required for one (1)
day's use as approved in the Blasting Permit application shall be
in accordance with all City, State and Federal regulations.
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* BLASTING MAY BE PERFORMED DURING DAYLIGHT HOURS ONLY, NO EXCEPTION.
| ||
* NO BLASTING SHALL TAKE PLACE AT ANY SITE WITHOUT FIRST NOTIFYING
THE FIRE DEPARTMENT ALARM OFFICE AT 969-7360, AND PUBLIC WORKS INSPECTIONS
AT 537-6969.
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Applicant acknowledges that he has read and agrees to comply
with the Blasting Regulations of the City of Greenwood.
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Applicant's Signature: __________ Date: __________
Approved by: __________
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Denied by: __________
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Reason Denied: __________
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Date: __________
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Permit No: __________ Expiration Date: __________
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